Ask the doctor

What are biologic drugs?

Eczema Society of Canada asked leading Canadian dermatologist, clinical researcher, and atopic dermatitis (AD) expert Dr. Melinda Gooderham to help us better understand the use of biologic drugs in the treatment of AD. The first biologic drug for atopic dermatitis recently had it’s indication expanded to include patients 12 years of age and older. To learn more about biologic drugs for atopic dermatitis, read on.

What are biologic drugs?

Biologic drugs, sometimes called “biologics”, are a new type of medication approved for the treatment of AD. On a basic level, to create biologic drugs, scientists engineer proteins that come from living tissues or cells that are created in a laboratory.

How do biologics work to improve atopic dermatitis symptoms?

Our immune systems fight off harmful bacteria and viruses using proteins called interleukin, or IL for short. People with inflammatory conditions, like AD, have an overactive immune system. This overactive immune response causes the body to mistakenly attack itself. In AD, this overreaction results in inflammation of the skin caused by IL, and biologics work to block these proteins from binding to cell receptors. This stops the process of immune overreaction and stops the cycle of inflammation.

How does a patient take a biologic drug?

Biologics are not a topical treatment (such as a cream) or an oral treatment (such as a pill). Biologics are taken through the skin (with a needle injection) or intravenously (through the veins). In the case of AD, the first biologic developed is dupilumab, and it is taken by injection.

Are biologic drugs safe?

Overall, biologics are a safe class of medication, but all medications carry the risk of side effects, and it is always advisable to discuss these risks with your own doctor. It is especially important to talk to your doctor if you are trying to conceive, become pregnant, or are breastfeeding.

Are biologics a new class of medication?

Biologics have been used for over a decade to treat other conditions including psoriasis, rheumatoid arthritis, and inflammatory bowel conditions.

Which AD patients would benefit from biologic drugs?

For many patients with AD, appropriate skin care such as bathing and moisturizing, along with topical treatments, will manage their condition. However, for some patients who live with moderate-to-severe AD, the current therapies may not adequately control their disease and they may benefit from a biologic.

Why are biologics so expensive?

Biologic drugs are expensive because they represent a major advancement in the treatment of inflammatory conditions. The research and development of biologic drugs takes many years and is a very expensive process.

Dr. Melinda Gooderham is a dermatologist and clinical researcher based in Peterborough, Ontario. Eczema Society of Canada thanks Dr. Gooderham for her volunteer contributions to this content, which was originally published as an ESC Ask the Doctor series resource.